1.0 Introduction
1.1 Background of Study
Historically, infant mortality rates spans centuries, with notable changes driven by improvements in public health, sanitation, and medical care. In ancient times, infant mortality was universally high due to limited medical knowledge, poor hygiene, and a lack of organized healthcare systems. High infant death rates were considered an unfortunate but inevitable part of life. For instance, in pre-industrial societies, infant mortality rates were often over 200 deaths per 1,000 live births, with diseases such as pneumonia, diarrhea, and malnutrition being among the leading causes of death (World Health Organization, 2019).
Infant mortality remains one of the most important public health indicators globally, reflecting not only the health of infants but also the broader socio-economic conditions and the quality of healthcare systems in a given population. The term "infant mortality" refers to the death of children under the age of one year. It is a critical measure of a country's development, often linked to the level of maternal care, accessibility of healthcare facilities, immunization programs, and the general economic status of the nation (United Nations Children's Fund [UNICEF], 2020).
Over the years, many regions, particularly in low- and middle-income countries, have struggled to significantly reduce their infant mortality rates. High infant mortality rates are often attributed to factors such as malnutrition, lack of proper prenatal and postnatal care, poor hygiene practices, and limited access to medical services (World Health Organization [WHO], 2021). The presence of infectious diseases, such as pneumonia, diarrhea, and malaria, plays a significant role in the preventable deaths of infants, especially in sub-Saharan Africa and South Asia, where healthcare infrastructure may be inadequate (Lawn et al., 2014).
The World Health Organization (WHO) and UNICEF have placed significant emphasis on reducing infant mortality through initiatives aimed at improving maternal health, reducing neonatal infections, and increasing access to skilled birth attendants. Strategies such as enhancing immunization coverage, promoting breastfeeding, and improving sanitation have also been recognized as essential measures to combat the high rates of infant mortality (WHO, 2019). Despite these efforts, disparities still exist in the rates of infant mortality across different regions and socio-economic groups. Studies have shown that countries with high rates of poverty, lower educational levels, and insufficient healthcare infrastructure are more likely to experience higher infant mortality rates (Black et al., 2013).
Infant mortality according to WHO (2021) refers to the death of infants before their first birthday. It is a critical indicator of the overall health of a population and is often used to assess the effectiveness of healthcare systems, maternal health, and the socio-economic conditions of a country (World Health Organization [WHO], 2021). In many developing countries, infant mortality remains a significant public health concern, with rates higher than in developed countries due to various socio-economic, environmental, and healthcare-related factors (United Nations Children's Fund [UNICEF], 2020).
Lawn et al. (2014) asserted that infant mortality is often caused by a combination of preventable factors, such as poor prenatal care, lack of access to medical facilities, infectious diseases, malnutrition, and inadequate sanitation (Lawn et al., 2014). The rate of infant mortality is often used as a benchmark to measure the effectiveness of healthcare interventions and the standard of living in a given region. Efforts to reduce infant mortality include improving maternal health, providing better neonatal care, enhancing immunization coverage, and addressing the underlying social determinants of health (WHO, 2019). Therefore, this study aims to explore the various factors contributing to infant mortality.
1.2 Statement of Problems
Investigation revealed that infant mortality continues to affect millions of children worldwide, particularly in low- and middle-income countries. Despite significant advances in medical care and public health over the last few decades, the rate of infant deaths remains high in many regions. The causes of these deaths are often multifaceted, involving complex interrelations between socioeconomic factors, healthcare access, and environmental conditions. In many developing countries, inadequate healthcare infrastructure, poor maternal care, malnutrition, and infectious diseases are some of the main contributors to the preventable deaths of infants (World Health Organization [WHO], 2021).
Furthermore, malnutrition is a significant factor contributing to infant mortality. Poor maternal nutrition during pregnancy leads to low birth weight, which is one of the leading causes of infant deaths in the neonatal period. Even after birth, many infants suffer from insufficient nutrition due to poverty, lack of breastfeeding, and inadequate weaning practices (Lawn et al., 2014). It is against the backdrop that this study aims to explore these complex issues surrounding infant mortality and identify potential solutions to reduce the rate of infant deaths.
1.3 Aim and Objectives of Study
The primary aim of this study is to investigate the rate and causes of infant mortality. The specific objectives of the study are as follows:
- To examine the current rate of infant mortality in various regions and assess how these rates vary based on socio-economic factors, healthcare access, and geographical locations.
- To identify the major causes of infant mortality, including diseases, malnutrition, and maternal health issues, and evaluate how these causes differ between different socio-economic groups.
- To assess the role of healthcare infrastructure and access to medical services in preventing infant deaths, with a particular focus on the availability and quality of prenatal and postnatal care.
- To analyze the impact of cultural and societal factors on infant mortality rates, including maternal health practices, beliefs, and health-seeking behaviors.
- To evaluate the effectiveness of existing global health initiatives in reducing infant mortality, including vaccination programs, maternal health interventions, and neonatal care services.
- To recommend strategies and interventions that could be implemented to reduce infant mortality, with particular attention to low-income and rural areas where the rates are highest.
1.4 Research Questions
Based on the objectives of this study, the following research questions are formulated:
- What is the current rate of infant mortality in different regions, and how do these rates vary based on socio-economic factors, healthcare access, and geographical locations?
- What are the major causes of infant mortality, and how do these causes differ across various socio-economic groups?
- How does healthcare infrastructure, including the availability and quality of prenatal and postnatal care, impact the prevention of infant deaths?
- In what ways do cultural and societal factors, such as maternal health practices, beliefs, and health-seeking behaviors, contribute to infant mortality rates?
- How effective are existing global health initiatives, including vaccination programs, maternal health interventions, and neonatal care services, in reducing infant mortality?
- What strategies and interventions can be recommended to reduce infant mortality, particularly in low-income and rural areas, where the rates are highest?
1.5 Research Hypothesis
In order to pursue the objective of this study, the following generalized statements have been designed to guide and aids in obtaining the result for the experiment to be conducted. For this work, the null hypothesis will be represented with H0 while the alternative hypothesis will be represented with hypothesis H1.
Hypothesis One
- H0: There is no significant relationship between socio-economic factors, healthcare access, and the rate of infant mortality in different regions.
- H1: There is a significant relationship between socio-economic factors, healthcare access, and the rate of infant mortality in different regions.
Hypothesis Two
- H0: Inadequate healthcare infrastructure does not significantly contribute to the rate of infant mortality.
- H1: Inadequate healthcare infrastructure, including limited access to prenatal and postnatal care, is a major contributing factor to higher rates of infant mortality.
1.6 Significance of Study
The outcomes of this study will help international health organizations and governments to refine their health policies, programs, and resource allocation aimed at improving maternal and child health. It will also serve as a foundation for ongoing efforts to ensure that every infant has a chance to survive and thrive, especially in low-resource settings where mortality rates remain disproportionately high.
Lastly, the research will also contribute to the body of knowledge on maternal and child health, shedding light on how better healthcare infrastructure, improved prenatal and postnatal care, and accessible medical services can reduce infant deaths.
1.7 Scope of Study
This study will focus on the rate and causes of infant mortality in Enugu State, Nigeria. The research will specifically examine infant mortality within both urban and rural areas of the state to understand how healthcare access, socio-economic factors, and environmental conditions contribute to the disparity in mortality rates.
1.8 Limitations of the Study
The research study was affected by delays from respondents, as many healthcare providers and participants were often unavailable or slow to respond to survey requests and interview schedules. This delayed the overall data collection process, which impacted the timely completion of the study.
Additionally, financial and time constraints were limitations that restricted the scope of the study. The research team was constrained by limited funding, which affected travel to remote areas and access to certain resources. The time allocated for data collection was also limited, preventing the research from being as expansive as initially planned, and this constrained the ability to gather comprehensive data across a wider area.
1.9 Definition of Terms
Infant Mortality:
Infant mortality refers to the death of a live-born child within the first year of life. This term is commonly used as a key indicator of the overall health of a population, as it reflects the availability and quality of maternal and child health services, as well as the broader socio-economic conditions affecting the survival of infants (World Health Organization, 2020).
Infant Mortality Rate (IMR):
The Infant Mortality Rate (IMR) is the number of infant deaths (under one year of age) per 1,000 live births in a given year or period. It is often used as a key measure to assess the effectiveness of health systems, particularly in low-income and middle-income countries, where higher rates are frequently observed due to limited healthcare access (UNICEF, 2021).
Neonatal Mortality:
Neonatal mortality refers to the death of an infant within the first 28 days of life. Neonatal mortality is particularly crucial in understanding the early health challenges infants face, including complications from birth, infections, and conditions related to prematurity (UNICEF, 2021).
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